Use of the Fagerström test to assess differences in the degree of nicotine dependence in smokers from five ethnic groups: The HELIUS study. (1st January 2019)

• Record Type: Journal Article
• Authors: van Amsterdam, Jan; Vorspan, Florence; Snijder, Marieke B.; van den Brink, Wim; Schene, Aart H.; Stronks, Karien; Galenkamp, Henrike; Derks, Eske M.
• Is Part Of: Drug and alcohol dependence. Volume 194(2019)
• Page Start: 197
• Page End: 204
• Publication Date: 2019-01-01
• Subjects: FTND -- Smoking -- Dependence -- Measurement invariance -- Factor analysis -- Ethnicity -- HELIUS study; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2018.10.011
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: "Morning smoking" and "smoking patterns" explained variation in Fagerstrom Test for Nicotine Dependence (FTND) items. FTND items show differential item functioning across ethnic groups. Smokers of 3 out of 4 ethnic minorities score higher on ND compared to ethnic Dutch. Abstract: Background: The prevalence of smoking varies across ethnic groups in developed countries, but little is known about ethnic variations in specific aspects of nicotine dependence (ND). We conducted item-response analyses in current smokers to compare ND factors across five ethnic groups. Methods: Data were obtained from a population-based, multi-ethnic cohort study conducted in the Netherlands. The Fagerström Test for Nicotine Dependence (FTND) was assessed in 1147 Dutch, 991 South-Asian Surinamese, 1408 African Surinamese, 1396 Turkish, and 584 Moroccan smokers (N = 5526). We tested whether the factorial structure of the FTND was invariant across ethnic groups using a multi-group confirmatory factor analysis. FTND item and total scores and factor means were compared across groups. Results: The two-factor model representing "morning smoking" and "smoking patterns" provided an adequate fit. The items "Cigarettes smoked daily" and "Time until first cigarette" showed differential item functioning (DIF) as a function of ethnicity. Three out of four ethnic minority groups scored significantly higher on both factors compared to the Dutch origin group (all p < 0.001) before and after taking DIF into account, while the African Surinamese scored higher only on "morning smoking" when DIF was accounted for. Discussion: The factor structure of the FTND is not measurement invariant across ethnic groups in this population-based sample. Accounting for DIF affecting the nicotine dependence factor scores, although South-Asian Surinamese, Turkish, and Moroccan groups showed higher levels of dependence than the Dutch origin group, genetic as well as environmental factors may account for the observed differences.